APMLE Part III Practice Questions - American Podiatric Medical Licensing Examination Part III (Licensure) Exam

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A 62-year-old diabetic with HbA1c 9.4% has a 3-week-old plantar 2nd metatarsal head ulcer (2 cm, full thickness, exposed tendon). Probe-to-bone is positive. WBC 12,500, ESR 92, CRP 8.5. X-ray shows cortical erosion of the 2nd metatarsal head. Next best step is:

Outpatient oral cephalexin alone Admit for IV antibiotics (vanco + pip-tazo), MRI to define osseous extent, surgical debridement with bone biopsy/culture, glucose control, vascular workup Wait 2 weeks and reassess Topical silver dressing only

Correct Answer:

Admit for IV antibiotics (vanco + pip-tazo), MRI to define osseous extent, surgical debridement with bone biopsy/culture, glucose control, vascular workup

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